• Masafumi Nakayama, Masahito Sato, Hitoshi Kitazawa, Atsushi Saito, Yoshio Ikeda, Satoru Fujita, Koichi Fuse, Minoru Takahashi, Ken Takarada, Takeo Oguro, Hirooki Matsushita, Masaaki Okabe, Akira Yamashina, and Yoshifusa Aizawa.
• Tachikawa General Hospital, Cardiovascular Center, Nagaoka, Japan.
• Europace. 2013 Jan 1; 15 (1): 109-15.

AimsThe prevalence, clinical significance, and pathogenesis of J-waves were studied in the patients with an ST-elevation myocardial infarction (MI) after percutaneous coronary intervention (PCI).Methods And ResultsOne hundred and fifty-two consecutive patients with an acute ST-elevation MI were included. The mean age was 68.6 ± 13.5 years, and 78.3% of the patients were male. Following successful PCI, 12-lead electrocardiograms (ECGs) were monitored, and J-waves were measured 1 week after the MI and analysed in relation to the location of the MI and arrhythmias. Clinical and ECG parameters were compared between the groups with and without J-waves. The rate dependency of the J-wave amplitude was analysed in the conducted atrial premature beats (APBs). J-waves were present in 60.5% (≥0.1 mV) or 48.9% (≥0.2 mV) of the 152 patients. The J-waves were more often located in the inferior leads and more frequently in an inferior MI. The presence of J-waves was associated with ventricular arrhythmias, including ventricular fibrillation. The J-wave amplitude increased in the conducted APB, mechanistically suggesting a phase 3 block.ConclusionMany patients in the early recovery phase after an acute MI had J-waves. This ECG phenomenon was associated with an increased incidence of ventricular arrhythmias. The tachycardia-dependent augmentation of the J-wave amplitude suggested a mechanistic role of conduction delay.

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